The debate for and against circumcision has been going on for centuries, and both sides have evidence and rationale to support their claims.
One of the more popular arguments that has risen against circumcision is its potential connection to erectile dysfunction. Does circumcision cause ED? The research suggests circumcision and ED are not related, but substantial differences between circumcised penises and uncircumcised DO exist. Here's what to know.
What Is Erectile Dysfunction?
Erectile dysfunction is defined as the inability to, or difficulty in, achieving or maintaining an erection firm enough for sex. There are many physical causes of ED, including heart disease, high blood pressure, diabetes, and more, many of which revolve around cardiovascular function. Psychological causes play a role as well, with ED connected to depression, stress, anxiety, and more.
Due to the fact that there are so many potential causes and risk factors, it can be difficult to determine the exact reason why erectile dysfunction is happening. In most cases, prescription ED medications can help to improve blood flow enough that an erection is possible, but these are not a permanent cure.
The best way to reduce erectile dysfunction lies in treating the root cause of the issue. For example, lowering high blood pressure with diet and exercise can dramatically improve erectile function. Improving diabetes management can help to reduce the symptoms of ED.
But what happens if the root cause was a surgical procedure performed as a baby?
What Is Circumcision?
Circumcision is the surgical removal of the foreskin that covers the tip of the penis. It's the oldest known surgical procedure for humans, with evidence dating back thousands of years and as far as back as the 23rd century B.C.
Currently it’s estimated that about one in three men worldwide are circumcised for religious, cultural, medical, traditional, hygienic, or personal reasons. In the United States the rates are much higher, ranging between 76% and 92% of men.
The procedure is fairly simple and typically performed within 10 or so days of being born, though it's often done in the nursery at the hospital or birthing facility. The surgery only takes about 10 minutes.
Why Get Circumcised?
While the process of circumcision is often associated with Jewish and Islamic religious rituals, there are health benefits that have spread the practice to other faiths and non-religious individuals as well.
Research has shown that circumcision can improve penile hygiene, reduce the risk of urinary tract infections and sexually transmitted diseases, protect against cancer in female partners, and prevent phimosis, paraphimosis, and balanoposthitis from occurring.
Meanwhile, opponents point out that these are all uncommon occurrences in our modern, hygienic society anyway, and some consider circumcision to be a form of genital mutilation. Circumcision can reduce penis sensitivity, and opponents believe it should be a personal choice, not a parent's choice.
Ultimately, the debate continues as to whether circumcision should be recommended for use on a worldwide scale. While the potential health benefits may outweigh the risks involved, it’s ultimately a voluntary operation on which new parents must decide in our current system.
How Does Circumcision Affect Sexual Function?
When it comes to erectile dysfunction, circumcision seems to have no significant impact. The act of circumcision is largely a cosmetic one, and erectile dysfunction is mostly an issue related to blood flow.
Whether circumcised or not, erectile dysfunction is a possibility for men of all ages.
Claims have circulated that erectile dysfunction is more likely in circumcised men, but these claims have largely been debunked. A 2013 meta-analysis that evaluated 10 studies and 9317 circumcised and 9423 uncircumcised men, concluded, "In summary, male circumcision does not appear to adversely affect penile sexual function or sensitivity when compared with uncircumcised men."
Still, there are some fairly substantial differences between the two that could have both positive and negative impacts on sex.
Appearance
Though everyone's member is different, it's generally easy to tell the difference between a circumcised and uncircumcised penis when flaccid. An uncircumcised penis will make the penis look slightly more bulky and bigger as the foreskin covers the head of the penis, similar to a long turtleneck.
During an erection, the foreskin retracts and practically disappears, and its appearance resembles that of a circumcised penis. Contrary to popular belief, circumcision does not have any impact on penis size. The foreskin is merely a layer of protective skin and has no bearing whatsoever on how large the penis can be. That's based mostly on inherited genetics and blood flow.
Hygiene and Sensitivity
These two factors are probably the most significant differences between circumcised and uncircumcised penises. Penile hygiene is one of the most popular arguments for circumcision, but the potential reduction in sensitivity is one of the more popular counter-arguments.
An uncircumcised penis requires greater care in order to remain clean. The area underneath the foreskin must be regularly attended to, otherwise bacteria, dead skin cells, and oil can contribute to infection or soreness. This is what is known as smegma, which can cause an intense and unpleasant odor in addition to head and foreskin inflammation, called balanitis. Smegma is the term for the same buildup in the vagina as well. Balanitis can result in the pulling back of the foreskin becoming difficult or even impossible in severe cases. These severe cases are called phimosis and may require medical attention.
On the other hand, a circumcised penis merely requires regular washing during bathing in order to maintain a reasonable level of cleanliness.
While the foreskin requires greater care, in today's hygienic society with men bathing daily or nearly daily, the foreskin is generally not an issue.
Sensitivity is where circumcision proponents and opponents get a little more hung up. The foreskin normally protects the sensitive penis glans, or head, which is where most of the nerve endings in the penis reside. It's the most sensitive part of the penis. As a result, the penis head in men circumcised at birth may face desensitization due to rubbing against underwear, etc. throughout life. At least, that's the argument from circumcision opponents.
Research suggests the differences in sensitivity may be minimal. There has been conflicting research that suggests men that have undergone circumcision are more likely to have difficulties with reaching orgasm. This research suggests loss of sensitivity is the cause, but there has been no definitive research to support this theory.
There are no studies to suggest that this sensitivity carries over to sexual intercourse.
Function
One of the lesser known effects of circumcision is the loss of lubrication. During sex, the foreskin provide a natural form of "lubrication" to the penis and help to reduce the overall friction of intercourse.
Overall, there is no evidence to suggest a decrease in penile health or satisfaction in circumcised men.
The overall functionality of sperm isn't affected by circumcision either, as the production and storage of sperm occurs in the testicles. Sperm production and health are largely influenced by diet, lifestyle, and overall health.
Protections
Another huge divide in the debate for circumcision is the protections that it seems to offer. An uncircumcised penis is more likely to contribute to the development of urinary tract infections. Although it's most common in newborn babies less than a year old, the risk is still higher during adulthood.
Research also suggests that a circumcised penis is between 50% and 60% less likely to contract the human immunodeficiency virus (HIV) from female partners. For this reason, circumcision has become highly popular in countries that have experienced widespread HIV.
It has also been shown that circumcision can result in a reduced risk of contracting genital herpes and human papillomavirus (HPV). Not only can these sexually transmitted infections cause genital warts, but HPV is the main risk factor for cervical cancer in women.
Speaking of cancer, circumcised men are less likely to develop penile cancer. The buildup of smegma can cause phimosis and balanitis, which are some of the main risk factors for penile cancer.
With proper hygiene, issues related to smegma can be avoided, but they are virtually nonexistent with a circumcised penis.
The Takeaway: When it comes to erectile dysfunction, there doesn’t appear to be any connection to circumcision. There are hygiene and health benefits to circumcision.
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